Mark W Stenvall, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

013663 Issued in NJ

Practice address

410 State Route 10
Suite 209
Ledgewood, NJ 07852-9658

Phone

(973) 598-0800

Fax

(973) 598-0805

NPI assigned

Apr 12, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689898314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 STATE ROUTE 10",
            "address_2": "SUITE 209",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078529658",
            "telephone_number": "973-598-0800",
            "fax_number": "973-598-0805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 STATE ROUTE 10",
            "address_2": "SUITE 209",
            "city": "LEDGEWOOD",
            "state": "NJ",
            "postal_code": "078529658",
            "telephone_number": "973-598-0800",
            "fax_number": "973-598-0805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STENVALL",
        "first_name": "MARK",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "013663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shivaniben Shah
• Marie Dominique Importante Sia, PHARMD, RPH
• Skylands Wellness, LLC
• Anastasia L Stack
• Michael Alan Stein, M.D.
• Ryan Mark Stenvall, D.M.D.
• Sweet Home Laboratory Services
• Nicole Syristatides
• Meetal Dhansukh Tailor, O.D.
• Jonna Jessica Tellish

• General Practice Dentistry in Ledgewood, NJ
• Providers in Ledgewood, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.